Despite the recent surge in COVID-19 cases, San Juan County Regional Medical Center and San Juan County, New Mexico, officials are cautiously optimistic about the changing public health situation across the region.
As of Thursday, San Juan County had recorded a total of 4,289 COVID-19 cases, which was up 123 cases from Tuesday. The county has reported 207 deaths. According to the New Mexico Department of Health, between Oct. 27 and Nov. 9, San Juan County’s positivity rate was 9%, meaning about one in 10 people who got tested had positive results for the virus.
Dr. Brad Greenberg, emergency physician and medical director of emergency preparedness at San Juan Regional Medical Center, said the county is seeing a considerable uptick in both absolute cases and hospitalizations. Greenberg said the most recent surge became noticeable in the third week of October.
However, Greenberg said he is confident the incident command structure at the hospital can adjust to the rapidly changing situation. The incident command team has been in place since February and includes leaders from different sectors within the hospital, like human resources, finance and logistics. The team meets every day and ensures the hospital has enough personal protective equipment, can meet testing need and is adequately staffed.
Part of the work of the incident command team has been to increase the capacity of the hospital. Since February, the hospital has increased the intensive care unit capacity by nine beds, while creating two different ICUs – one for COVID-19 patients and one for non-COVID-19 patients. The hospital is also working on adding intermediate care beds.
“We’re trying to increase not only our capacity, but our capability, as well,” Greenberg said.
On Wednesday, the hospital had 38 people on its COVID-19 floor. Thirty-five of those patients were COVID-19-positive, while the other three were assumed positive, but officially deemed “patients under investigation.”
Illustrating the nuance and difficulty of responding to a health crisis, Greenberg said adding more hospital beds, while necessary for a surge, can create staffing problems. To ensure there are no staffing shortages, the hospital has “alternative care plans” in place that can be activated at any time and allow the nurses to cover more ground than usual with the help of support staff members.
The hospital is also in constant communication with community leaders to ensure the community and hospital are working in conjunction to respond to the virus.
Greenberg cited the leadership of San Juan County Emergency Manager Mike Mestas, and said, “We’ve really benefited from strong emergency preparedness leadership at San Juan County.”
Greenberg said Mestas has done an excellent job of consistently meeting with community stakeholders over the past nine months to ensure everyone in the county is operating with the same information and is working toward the same goal.
On Monday, out of an abundance of caution, Mestas moved the county from Level 2 emergency preparedness, “partial activation,” to Level 3, “full activation.” Mestas said the move was purely precautionary and did not signal an inability of his office to respond to current community needs. Mestas echoed Greenberg’s confidence in the county’s preparedness.
Devin Neeley, spokesman for the county, said, “At this moment, all organizations seem adequately prepared.”
Neeley said the two key differences that put the county in a better position now than in the spring are better communication between organizations and time to learn from the spring response efforts.
Neeley said he is “cautiously optimistic that we are at least better prepared than March.”
Yet, despite the higher levels of confidence in the hospital’s and county’s ability to respond to changing circumstances, Greenberg urged community members to take the virus seriously.
“We are absolutely concerned. This is truly a real bona fide public health emergency. It is absolutely imperative that people heed the warnings of all the different public health authorities,” Greenberg said. “Our collective ability to navigate out of this public health emergency depends on the sum of everyone’s individual decisions.”
Greenberg emphasized the importance of keeping COVID-19 under control to allow the hospital to treat patients who are not infected with COVID-19.
He cited other hospitals in the state that have been forced to limit care to non-COVID-19 patients and said San Juan Regional Medical Center is working hard to ensure care to all patients stays open. The impact of the virus cannot be measured only in the number of COVID-19 cases, but also in how much it impacts the ability of other patients to receive care. Greenberg urged community members not to “let COVID-19 be a reason you stay away from the hospital.”
Summarizing the hospitals efforts, Greenberg said, “This is sort of like trying to set the stage to step into the unknown. We’re trying to set the stage to be ready to handle the challenges that are in front of us that perhaps we can’t anticipate, but we’ll do our best to meet those challenges and also meet the health care needs of the folks in the Four Corners.”